Vaya Health

Manager

• Innovations Care Manager provides proactive intervention and coordination of care to eligible Vaya Health members across MH/SU/IDD/TBI, physical health, pharmacy, LTSS and unmet health-related resource needs.
• Mobile position with work in members’ home communities and various locations; requires in-person contacts and travel within NC
• Works with care team and community stakeholders; uses Care Management platform and maintains HIPAA-compliant records
• Administers Health Risk Assessments (HRA) and other screenings; informs Care Planning and self-management strategies
• Develops and updates person-centered Care Plans with specific services addressing mental health, substance use, medical and social needs
• Participates in multidisciplinary care team meetings; coordinates transitional care and diversion from institutional placement
• Ensures Care Plans meet NCDHHS requirements and monitors progress
• Maintains documentation in the AHR; verifies Medicaid eligibility; submits SARS; ensures compliance with contracts

Innovations Care Manager

Network Engineer

Provider Network Analyst

• Provides proactive intervention and coordination of care to Vaya Health members to ensure appropriate assessment and services.
• Works with member and care team to alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services across MH/SU/IDD/TBI/physical health/pharmacy/LTSS.
• Mobile position with work done in a variety of locations, including members home communities.
• Performs Health Risk Assessments (HRAs) and comprehensive bio-psycho-social assessments.
• Adheres to medication lists and continuity of care processes.
• Participates in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management.
• Transitional Care Management and Diversion from institutional placement.
• Ensures Care Plan includes elements required by NCDHHS and maintains documentation in the AHR.
• Collaborates with care team and providers to ensure quality, safety and outcomes.
• Maintains compliance with HIPAA and authorization for release of information.

Care Manager

• The Care Manager is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members; ensures appropriate assessment and services across MH/SU/IDD/TBI, physical health, pharmacy, LTSS and unmet health-related resource needs.
• This is a mobile position with work done in a variety of locations, including members’ home communities; travel required.
• Works with the member and care team to alleviate inappropriate levels of care or care gaps; conducts Health Risk Assessments (HRA); adherence to HIPAA; uses Vaya’s Care Management software platform/AHR; linkage and coordination of services.
• Develops a person-centered Care Plan; ensures Care Plan includes all elements required by NCDHHS; engages care team; monitors progress; updates annually or on significant life changes.
• Coordinates with RN, pharmacist, and other clinicians; facilitates care team meetings; supports Transitional Care Management; Diversion from institutional placement; crisis planning; and discharge follow-up.
• Requires NC residency or residence near NC counties served; travel in NC; remote work with local in-person contacts as needed.
• Collaborates with community stakeholders; cross-functional meetings; supports quality and compliance with standards; maintains documentation in AHR; participates in training.